Eating disorders
Definition An eating disorder is a compulsion in which the main problem is a person eats in a way which disturbs their physical health. The eating may be too excessive (compulsive over-eating), too limited (restricting), may include normal eating punctuated with episodes of purging, may include cycles of binging and purging, or may encompass the ingesting of non-foods. There are several main eating disorders for details of their treatment etc see: * Anorexia nervosa * Binge eating disorder * Bulimia nervosa * Diabulemia * Eating disorder not otherwise specified * Hyperphagia * Kleine Levin syndrome * Night eating syndrome * Obesity * Pica * Rumination * Toxicomania Diagnosis The diagnosis of eating disorders can be problematic in that a number of physical disorders can underpin the condition that will make a psychological approach inappropriate so it is important that psychologists ensure that all potential clients have been physically screened by a qualified physician to exclude these factors Assessment * Eating Attitudes Test Eating disorders are characterized by an abnormal obsession with food and weight. Eating disorders are much more noticed in women than in men. This can be attributed to the fact that society is seen to put an emphasis on woman to be thin, and men to be 'bulked up'. This can lead to pressure on woman to be 'picture perfect', and an eating disorder prevails as a result of stress of not being able to reach unattainable goals related to this 'picture perfect' ideal. Also, it can be due to the fact that men are less likely to seek help. Some psychologists also classify a syndrome called orthorexia as an eating disorder, or, more properly, "disordered eating" - the person is overly obsessed with the consumption of what they see as the 'right' foods for them (vegan, raw foods, etc), to the point that their nutrition and quality of life suffers. In addition, some individuals have food phobias about what they can and cannot eat, which some also call an eating disorder. Another condition that is somewhat qualitatively different from those previously mentioned is pica, or the habitual ingestion of inedibles, such as dirt, wood, hair, etc. This is a condition particularly prevalent in children. Comorbidity Over 50% of the sufferers of an eating disorder also have a comorbid diagnosis of severe mental depression. The American Psychiatric Association lists eating disorders and severe depression as primary diagnoses. Additional main articles . . . . . . . . . . . . . Pathogenesis Psychologists prefer to class the other syndromes as "mental disorders", referring to the mental health model, which views the syndrome as caused by something largely outside human will, or, more properly, a compulsion. Some eating problems, such as chronic overeating, are not always regarded as mental disorders, but as a lack of self-control, as the idea of "compulsion" suggests. Eating disorders are said to "interfere" with normal food consumption and be the antecendent for more serious health problems. Patients diagnosed with Bulimia nervosa and Anorexia nervosa have a mortality rate of between 5% and 12% per decade, which is a higher mortality rate than any other mental illness (Agras 2004). People whose eating is disordered often experience psychological decompensation, typically becoming obsessed with food, diet and, most often with Anorexia nervosa and Bulimia, body image. Clinically, the distortion of body image is called body dysmorphia. The overall health of the individual is at extreme risk due to malnutrition, as well as more indirect effects such as, heart arythmia, and even heart failure, an increase in hypertension (high blood pressure), electrolyte imbalances, cognitive deficits, and esophogeal difficulties. In the prevailing psychological view, patients with an eating disorder are seen as victims rather than as conscious actors. Again, the compusive aspects of the disorder are referenced here. Their suffering is not seen as self-inflicted, but as the result of a disease process. Most people with an eating disorder attempt to hide their abnormal behaviour from others. They do not accept the diagnosis, and will refuse treatment. As the treatments prescribed for eating disorders can take decades, mental health advocates warn that early "identification" of these disorders (and diagnosis of the syndrome as being caused by mental illness) may be the difference between life and death for the patient. There are many variations of Anorexia and Bulimia. An anorectic may himself/herself eat, but severely restrict the amount and/or specific foods he/she eats; or the eating pattern can progress to the point of literally starving consuming nothing. There are other forms of purging besides vomiting: such as compulsive exercise and laxatives. Often times sufferers fall under the category of "eating disorder not otherwise specified" (EDNOS) in which the eating disorder patterns vary; for example someone with EDNOS might fluctuate between compulsively eating and starving and occasionally purge. Women account for 90% of eating disorder cases. Not too long ago, this disease was considered typical of the Caucasian upper-middle class. In recent years, researchers have noted an increase in the Asian and Hispanic populations, as well as in men. In addition, although this disorder is most prevalent in young teens, the clinical community has, in recent years, seen an increase in the disease within the older female population. See Also * Aphagia * Appetite * Body awareness * Body image disturbances * Compulsive overeating * Coprophagia * Eating attitudes * Eating Disorders and Memory * Eating disorders in Chinese women * Feeding disorder * Food refusal * Hypergymnasia * Hyperorexia * Laxative abuse * Nausea * Nutritional deficiencies * Obesophobia * Orthorexia * Purging disorder * Rumination * Selective eating disorder * Starvation * Underweight References # Book reference * *Garner, D & Garfinkel, P E (Eds) (1997)Handbook of Treatment for Eating Disorders *Crisp, A, H, Joughin, N, Halek, C, Bowyer, C, (1996)Anorexia Nervosa and the Wish to Change (2nd Ed)Professorial Unit. St. Georges Hospital, London. *Fairburn, C G (1995)Binge Eating. Nature, Assessment and Treatment.Guilford Press: New York *Fallon, P, Katzman, M A & Wooley, S C (Eds) (1998) Feminist Perspectives on Eating Disorders.Guilford Press: New York *Miller, W R, & Rollnick, S (2002)Motivational Interviewing. Preparing People for Change (2nd Ed).Guilford Press: New York *Andersen, A E (2000)Making Weight: Men’s Conflicts with Food, Weight, Shape and Appearance.Gurze: Carlsband, Calif *Nasser, M, Katzman, M, A, & Gordon, R, A (Eds) (2002) Eating Disorders and cultures in Transition Brunner-Routledge *Ogden, J (2002)The Psychology of Eating: From Healthy to Disordered Behaviour *Bloom, C, Gitter, A, Gutwill, S, Kogel, L, & Zaphiropoulos, L (1994)Eating Problems: A Feminist Psychoanalytic Treatment Model Basic Books: New York *Brownell, K D, & Fairburn, C G (Eds) (1998)Eating Disorders and Obesity Guilford Press: New York *Crisp, A (1995)Anorexia Nervosa: Let Me Be Psychology Press *Herrin, M (2002)Nutrition Counselling in the Treatment of Eating Disorders. Brunner-Routledge *Johnson, C L (Ed) (1990)Psychodynamic Treatment of Anorexia Nervosa and Bulimia Nervosa. Guilford Press: New York *Kornstein, S, G, & Clayton, A, H (Eds) (2002)Women’s Mental Health. A Comprehensive Textbook Guilford Press: New York *Lask, B, & Bryant-Waugh, R (2000)Anorexia Nervosa and Related Eating Disorders in Childhood and Adolescence (2nd Ed)Psychology Press: Hove Blackwell *Szmukler, G, Dare, C, & Treasure, J (1995).Handbook of Eating Disorders.Wiley: Chichester *Treasure, J, Schmidt, U, & van Furth, E. (Eds) (2003) Handbook of Eating Disorders (2nd Ed)Wiley Journal references * : An excellent current article on the consequences of eating disorders, the costs to families and institutions. * * * * * Abstract: In a prospective long-term follow-up of 84 patients 21 years after first hospitalisation for anorexia nervosa, we found that 50.6% had achieved a full recovery, 10.4% still met full diagnostic criteria for anorexia nervosa, and 15.6% had died from causes related to anorexia nervosa. Predictors of outcome included physical, social, and psychological variables. *Denman, F. (1995) Treating eating disorders using CAT: two case examples. In Cognitive Analytic Therapy: Developments in Theory and Practice (ed. A. Ryle). Chichester: John Wiley. External links * F.E.A.S.T.'s Eating Disorders Glossary, A free online dictionary with more than 400 terms and concepts used in the diagnosis and treatment or eating disorders, disturbances and co-morbid conditions * Facts about Anorexia and Bulimia * Eating Disorders: Counseling Issues * Eating Disorder FAQs * Eating Disorders * Less-well-known eating disorders * Consequences of eating disorders * National Institute of Mental Health: Eating Disorders: A detailed booklet that describes symptoms, causes, and treatments, with information on getting help and coping. * Eating Disorders and Anorexia Nervosa - original review articles * Eating Disorder News * Somerset & Wessex Eating Disorders Association Eating Disorders support and information in Somerset, England Category:Eating disorders Category:Mental disorders Category:Physical disorders Category:Symptoms